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Observational Study
. 2023 Mar;53(4):1603-1610.
doi: 10.1017/S003329172100324X. Epub 2021 Jul 26.

Acute and longer-term psychological distress associated with testing positive for COVID-19: longitudinal evidence from a population-based study of US adults

Michael Daly  1 , Eric Robinson  2
Affiliations
Observational Study

Acute and longer-term psychological distress associated with testing positive for COVID-19: longitudinal evidence from a population-based study of US adults

Michael Daly et al. Psychol Med. 2023 Mar.

Abstract

Background: The novel coronavirus (SARS-CoV-2) has produced a considerable public health burden but the impact that contracting the disease has on mental health is unclear. In this observational population-based cohort study, we examined longitudinal changes in psychological distress associated with testing positive for coronavirus disease 2019 (COVID-19).

Methods: Participants (N = 8002; observations = 139 035) were drawn from 23 waves of the Understanding America Study, a nationally representative probability-based online panel of American adults followed-up every 2 weeks from 1 April 2020 to 15 February 2021. Psychological distress was assessed using the standardized total score on the Patient Health Questionnaire-4.

Results: Over the course of the study, 576 participants reported testing positive for COVID-19. Using regression analysis including individual and time-fixed effects we found that psychological distress increased by 0.29 standard deviations (p < 0.001) during the 2-week period when participants first tested positive for COVID-19. Distress levels remained significantly elevated (d = 0.16, p < 0.01) for a further 2 weeks, before returning to baseline levels. Coronavirus symptom severity explained changes in distress attributable to COVID-19, whereby distress was more pronounced among those whose symptoms were more severe and were slower to subside.

Conclusions: This study indicates that testing positive for COVID-19 is associated with an initial increase in psychological distress that diminishes quickly as symptoms subside. Although COVID-19 may not produce lasting psychological distress among the majority of the general population it remains possible that a minority may suffer longer-term mental health consequences.

Keywords: COVID-19; coronavirus infection; longitudinal research; mental health; nationally representative study; psychological distress.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf. MD has no conflicts of interest to declare. ER has been a named investigator on research projects funded by the American Beverage Association and Unilever, but does not consider this funding a conflict of interest.

Figures

Fig. 1.
Fig. 1.
Trends in psychological distress assessed using the PHQ-4 (range = 0–12) in the weeks before and after testing positive for COVID-19.
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